.JKEN3QS 


INAUGURAL  DISSERTATION  ...  DYSENTERY 


M-fclAS 


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Columbia  IBntoergitp 

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College  of  iPfjpgtctang  ano  gmrgeona 


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AN 

INAUGURAL  DISSERTATION, 

IN  WHICH,  BY  AN  INDUCTION  OF  FACTS  FROM 

DYSENTERY, 

THE 

MITCHILLIAN  DOCTRINE  OF  PESTILENTIAL   FLUIDS 
IS  ILLUSTRATED. 

SUBMITTED  TO  THE  PUBLIC  EXAMINATION  OF  THE 

FACULTY  OF  PHYSIC 

fcNDER  THE  AUTHORITY    OF    THE    TRUSTEES    OF  COLUMBIA  COLLEGE, 
IN  THE   STATE  OF   NEW-YORK, 

The  Right  Rev.  BENJAMIN  MOORE,  D.D.  President; 

FOR  THE  DEGREE  OF 

DOCTOR  OF  PHYSIC, 

On  the  9lh  Day  of  November,  1802. 


BY  NICHOLAS  I.  QUACKENBOS,  A.B. 

Citizen  of  the  State  of  New- York. 


- 


NEW-YORK.- 


Primed  by  T.  &  J.  StlroRD  ,  Printer!  to  the  Faculty  of  Physic 
ot   C'olumlii.i  L'ollcgc. 


1802. 


y&£r(JSH 


?~dM 


TO 

JOHN  R.  B.  RODGERS,  M.D. 

Professor  of  Obstetrics  and  Clinical  Medicine  in  Columbia  College  $ 

/ 

AND 

SAMUEL  L.  MITCHILL,  M.D.  F.R.S.E. 

Gentlemen, 

IN  the  dedications  of  books,  so  much  adulation  has  been 
frequently  poured  forth  to  the  patrons  of  authors,  as  to 
have  thrown  the  practice,  in  a  great  measure,  into  disrepute. 
When  a  young  writer,  however,  in  his  first  attempt  to  at- 
tract public  notice,  acknowledges  the  immense  obligations 
he  lies  under  to  that  gentleman  who  has,  with  unremitted 
assiduity,  conducted  him  in  the  pursuit  of  professional  know- 
ledge; and  when  he  expresses  his  gratitude  to  another, 
whose  name  is  deservedly  famous  in  the  republic  of  letters, 
for  his  polite  condescension  and  friendly  assistance,  while 
engaged  in  the  prosecution  of  his  studies ;  a  dedication,  in 
such  a  case,  will  be  universally  allowed  to  be  proper,  as 
silence  would  be  culpable;  and  the  highest  expressions  of 
esteem  and  respect  can  be  only  considered  as  the  effusions 
of  a  grateful  mind. 

Impressed,  therefore,  with  such  sentiments,  the  author 
conceives  it  a  tribute  no  less  due  to  superior  merit,  than  to 
principles  of  the  purest  gratitude  and  warmest  affection,  to 
itc  this  treatise  to  you,  to  whom  he  sincerely  wishes 
B  long  and  successful  continuation  of  your  truly  valuable 
labours, 


AN 

INAUGURAL  DISSERTATION 

ON 

DYSENTERY. 


CHAP.  I. 

LITERARY  AND  PHILOLOGICAL  REMARKS. 

XIl  GREAT  controversy  exists  among  Phy- 
sicians concerning  the  true  meaning  of  the 
words  Contagion  and  Infection.  Some  have 
considered  them  as  synonymous,  and  others 
have  contended  that  they  signify  things  of 
a  very  different  nature.  It  does  not,  per- 
haps, become  one  just  entering  into  the  pro- 
le--ion  to  decide  on  this  point,  upon  which 
men  of  bigh  character  and  eminence  have 
differed  so  widely:  yet  1  cannot  suppress  a 
belief  that  the  two  words  did  originally 
denote  ideas  very  unlike   each   other,    and 


(  ?  ) 

that  at  this  time  they  ought  not  to  be  con- 
founded. 

There  is  scarcely  an  instance  of  two  words 
in  the  English,  Latin,  or  any  other  language, 
possessing  the  same  critical  meaning.  Though 
in  common  speech,  they  may  be  employed 
as  convertible  terms;    yet  they  are  always 
found,  on  nice  examination,  to  have  a  plain 
and  sensible  difference.  The  books  of  rhetoric 
and  belles  lettres  inform  us  wherein  "  pride" 
differs  from  "vanity;"  how  "  fatigue"  is  dis* 
tinguished  from  "uneasiness;"  and  by  what 
means   "  delight"   varies  from  "  pleasure;" 
with  hundreds  of  other  examples  of  the  kind. 
These,  though  in  common  acceptation,  re- 
puted to  be  synonymous  words,  are  in  reality 
very  far  from  each  other  in  true  significa^ 
tion. 

What  happens  in  the  language  of  common 
life  occurs  also  in  the  dialect  of  medicine. 
Words  reputed  by  many  to  be  quite  alike,  are 
known  by  the  correct  and  learned  to  intend 
things  widely  remote  in  their  meaning.  Thus 
"  Lues,"  "  Pestis,"  "  Contagium,"  and  "  In* 
fectio,"  have  been  supposed  by  many  as 
words  of  signification  so  nearly  alike,  that 


(  7  ) 

in  glossaries  and  lexicons  they  have  been 
employed  familiarly  one  instead  of  the  other. 
But  I  shall  endeavour  to  show  that  this  is  a 
mistake. 

1.  "  Lues"  seems  to  be  derived  from  luo, 
to  pay  the  cost,  make  atonement,  or  suffer  punish- 
vient  for  a  crime  or  fault.  Hence  lucre  peenas 
signifies  to  suffer  the  penalty  for  an  omission 
or  breach  of  duty.  And,  for  the  same  reason, 
"  lues"  is  employed  to  mean  any  distemper 
brought  on  through  or  by  a  violation  of  moral 
obligation:  particularly  it  applies  to  the  dis- 
ease consequent  upon  scortatory  love,  which 
has  been  termed  emphatically  "  Lues  Vene- 
rea," the  malady  incident  to  prostituted  em- 
braces. Such  is  the  literal  and  original  mean- 
ing of  the  word ;  but  like  other  words,  it  ac- 
quired afterwards  a  greater  latitude  of  signifi- 
cation. 

Thus  Claud ian  the  poet  writes, 

"  Hinc  hominum,  pecudumque  lues,  hinc  pestifer  acr ;" 

alluding  to  the  sufferings  of  men  and  cattle; 
and  Virgil  goes  a  step  further,  and  extends 
the  idea  to  trees  and  corn: 

"  Ai  boi  iUr/jue  MLttsque  iucs,  et  kthifcr  annus.'* 


tl 


(     8     ) 

2.  Whether  "  Pestis"  is  derived  front! 
pereo,"  to  perish  or  to  die;  or  comes  from* 
the  Hebrew  "  paschat,"  importing  to  spoil  or 
pillage,  seems  not  necessary  now  to  be  dis- 
puted.*    It  is  sufficient  for  the  present  pur- 


*  Since  the  above  was  written  I  have  been  favoured  with 
a  letter  from  the  Rev.  J.  C.  Kunze,  S.  T.  D.  on  the  etymo- 
logy of  this  important  word.  The  remarks  of  this  gentle* 
man,  so  well  known  for  his  biblical  ar^d  oriental  erudition, 
are  so  valuable  that  I  insert  them  entire. 

"  New-Tork,  October  13,  1802. 
«  Dear  Sir, 

"  Accept  iny  hearty  thanks  for  the  permission  of  perusing 
your  Inaugural  Dissertation  on  Dysentery  in  manuscript^ 
which  I  herewith  return. 

"  The  derivation  of  the  word  pestis,  from  the  Hebrew  uiz/3, 
may  be  a  just  one,  as  the  word  is  used  for  undressing,  Lev* 
vi.  4.  Cant.  v.  3.  with  which  the  Hebrews  always  connect 
the  idea  of  weakening.  From  Judges  xi.  33.  it  appears,  like- 
wise, that  that  verb  has  the  signification  of  rushing  upon 
somebody  in  order  to  destroy  him.  In  the  most  places  it 
occurs  for  plundering ;  as  2  Sam.  xxiii.  10.  Nahurr  iii.  16* 
it  is  applied  to  the  mischiefs  of  the  canker-worm. 

"  It  seems,  however,  more  probable  to  me,  that  the  word 
arose  from  another  verb,  rr<P3,  passah,  which  signifies  ex- 
tending itself  and  making  progress.  So  much  I  can  assure 
you,  that  there  is  hardly  a  noun  in  Latin,  Greek,  English, 
or  German,  that  signifies  an  object  of  the  external  senses, 
and  certainly  very  few  that  denote  abstract  notions,  which 
could  not,  in  the  most  simple  and  obvious  manner,  be  de- 
rived from  Hebrew  roots.  It  would  be  a  pleasing  task  for 
one  who  had  time  to  compose  a  Dictionary  with  such  a  view. 
A  small  one  of  that  kind  I  have,  of  Jouchim  Lange,  under 
the  title  '  Subsidium  Harmonicum.' 

"  If  the  Hebrew  roots  do  not  lead  us  to  a  noun  of  a  simi- 
lar sound  in  the  more  modern  languages,  they  give  us  an 
idea  of  the  nature  of  the  thing,  and  in  this  striking  disco- 


(    a     ) 

pose  to  show  that  whether  the  former  or  latter 
etymology  be  adopted,  pestis  means  some- 


Veries  are  sometimes  made.  The  lion,  for  instance,  has 
seven  names  in  Hebrew ;  one  only  resembles  the  modern 
sound — x^1?,  lab'u  The  German  word  is  loewe,  with  which 
the  Latin  leo  has  a  similarity.  This  is  derived  from  joS 
carrying  the  notion  of  devouring:  but  all  the  others  point  at 
particular  properties  of  that  animal,  as  -IK,  at  tearing  to 
pieces  j  vsa,  at  its  strength ;  a'*1?,  at  its  superiority  ;  from 
which  comes  the  Greek  *k,  a  lion. 

"  The  chief  idea  the  scriptures  connect  with  the  plague, 
I  find,  is  that  of  diffusing  itself,  making  slow,  and,  to  the 
senses,  imperceptible  progress.  Hence  pestilence  is  said  to 
walk  in  darkness,  Ps.  xci.  6.  rrtpn  is  the  proper  verb  de- 
noting this,  and  is,  in  many  places,  used  for  the  plague,  as 
Lev.  xiii.  5,  6,  5 1,  5  5.  xiv.  39.  The  Hebrew  A,  I  must  here 
add,  is,  for  grammatical  reasons,  often  changed  to  t. 

"  Perhaps  you,  Sir,  and  your  medical  brethren,  will  par- 
don me,  if  I  draw  from  this  the  following  conclusion : — Epi- 
demical diseases,  which,  as  you  justly  have  observed,  may 
arise  from  various  causes — as  from  a  vitiated  atmosphere— 
from  provisions  used  by  people  living  in  a  district  together, 
&c.  have  not  the  name  of  pestilence  in  the  ancient  lan- 
guages, and  should,  perhaps,  not  be  called  so  in  the  mo- 
dern. Pestilence,  in  my  opinion,  arises  from  a  matter  con- 
cealed somewhere,  and  in  a  progressive  manner  diffusing 
itself  like  the  smoke  of  a  fire-brand,  with  this  difference 
only,  that  as  no  carbone  is  mixed  with  it,  as  with  the  smoke, 
this  matter  remains  invisible. 

"  That  you  step  forth  in  support  of  the  Mitchillian  doc- 
trine is  a  matter  peculiarly  pleasing  to  me.  In  Germany 
this  doctrine  gains  ground  every  where.  The  King  of 
Prussia  has,  on  account  of  this,  called  a  renowned  physi- 
cian, Dr.  Kciche,  with  a  handsome  salary,  to  Berlin  ;  and 
1  am  happy  to  hear  that  opposition  to  it  in  this  country  is  on 
the  decline. 

"  I  am,  with  particular  esteem, 

"  Your  most  Obedient]  humble-  si  rvant, 

«  JOHN  C.  KUN2E." 


(     io    ) 

thing  ruinous  and  destructive;  generally  ap- 
plying to  such  calamities  as  cannot  be  pre- 
vented by  human  foresight.  Pestilence  is 
therefore  coupled  by  Virgil  with  the  anger 
of  the  Gods: 

"  Pestis  et  ira  Deorum  stygiis  sese  extulit  undis." 

And  again  there  is  classical  authority  for  the 
following : 

"  Me  eruciat  sv&vo  pestis  violenta  vefteno  j" 

showing  that  the  word  originally  signified 
almost  any  unavoidable  distress;  and,  in  a 
limited  sense,  applied  particularly  to  disas- 
trous sickness,  and  endemic  distempers. 

3.  No  person  doubts  that  contages,  conta* 
gium,  and  contagio,  are  fair  derivatives  from 
contingo,  to  touch  or  be  in  contact.  Their 
primitive  sense  doubtless  was,  "  Diseases 
communicable  by  approximation  of  skin 
to  skin."  Hence  these  forms  of  expres- 
sion apply  peculiarly  to  gregarious  animals, 
as  sheep,  cattle,  and  the  human  species. 
Creatures  of  these  kinds,  herding  and  ming- 
ling together,  associating  while  they  feed, 
and  when  they  lie  down  to  rest,  are  remark- 
ably prone  to  catch  diseases  by  contact. 


(  11  ) 

In  this  strain  Melibceus  assures  Tetyrus  that 
(Virgil,  Eel.  i.  v.  51.)  the  noxious  contagion 
of  the  neighbour's  flock  shall  do  no  injury 
to  his: 

"  Nee  mala  vicini  pecoris  contagia  Indent." 

The  forms  of  expression,  when  either  of  these 
words  is  used,  are  adapted  to  give  an  idea 
of  something  creeping,  or  passing  off  from 
one  person  to  another — thus: 

"  Dira  per  in  incautura  serpunt  contagia  vulgus." 

And  again: 

"  Dira  per  omnes 
Manabant  populos  foedi  contagia  morbi." 

And  also: 

"  Invadunt  totum  contagia  morbida  regnum." 

From  these  authorities  it  would  seem  plain, 
that  the  popular  and  obvious  meaning  of 
contagion  could  scarcely  be  misunderstood, 
since  it  respected  merely  that  class  of  dis- 
orders among  men  and  brutes,  which  were 
imparted  from  one  to  another  by  contact \  as 
they  fed,  slept,  played,  and  associated  to- 
gether. 

Contagion  therefore  is  that  peculiar,  morbid 


(  1*  ) 

poison,  which  is  prepared  in  the  bodies  of 
living  animals,  especially  of  those  which  flock 
and  huddle  in  crowds,  and  is  wiped  off,  or 
is  communicated  by  touch  from  those  that 
are  contaminated,  to  those  which  too  nearly 
approach  them.  Such  was  the  common 
sense  of  mankind,  while  it  remained  un- 
wrarped  by  prejudice  and  forced  meanings. 
It  is  a  pity  that  such  unlettered,  though 
strong  common  sense  was  ever  departed  from. 

4.  "  Infection"  was  certainly  derived  from 
inficio.  This  word  was  of  very  various  and 
questionable  meaning  among  the  Romans. 
It  is  compounded  of  in,  negative,  and  facio, 
to  do,  signifying  to  undo,  or  rather  to  violate, 
to  corrupt,  to  taint,  or  to  tincture  any  thing. 
To  be  a  little  more  particular — the  verb  inficio 
expressed  that  property  of  an  agent,  by  which 
it  embued  the  substance  upon  which  it  acted, 
manifestly  and  glaringly  changed  its  qualities, 
and  altered  it  materially  from  what  it  ori- 
ginally was.  The  substance  or  thing  so  al- 
tered was  said  to  be  infected. 

One  of  :he  most  frequent  and  distinguish-, 
able  cases  of  infection  was  the  change  which 
white    cloths   underwent   by  dying.      The 


(      13     ) 

colouring  material,  or  the  dye-stuff,  was  the 
agent,  and  the  changing  or  vitiating  the  white 
colour  by  its  tinging  property,  was  said  to  in- 
fect or  stain  the  fabric ;  its  whiteness  was  al- 
leged to  be  overcast,  polluted,  spoiled,  or  un- 
done. 

So  when  the  clear  and  fine  atmosphere  was 
vitiated  by  mixtures  of  noxious  vapours,  and 
poisonous  gases  extricated  from  corrupting  bo- 
dies, it  was  declared  to  be  infected.  The  pure 
air,  like  the  white  cloth,  had  acquired  a  fo- 
reign tincture ;  and  this  effect,  wrought  upon 
the  respirable  and  healdiy  atmosphere  by  the 
adventitious  material  with  which  it  was 
charged,  was,  in  a  figurative  sense,  denomi- 
nated infection.  The  air  so  vitiated  or  cor- 
rupted, so  different  in  its  constitution,  and  so 
altered  from  what  it  was,  literally  speaking, 
had  become  infected,  or  "  vifectus,,f  that  is, 
undone,  or  spoiled  for  the  purposes  of  its  pri- 
mitive and  ordinary  destination.  Air  thus 
vitiated  was  infected  air. 

In  like;  manner,  a  healthy  animal  might  be 
infected  by  coming  into  an  atmosphere  of 
-in  li  a  tint  lure,  or  so  corrupted.  An  exter- 
nal igeol  of  this   kind   could  infect  or  undo 


(     I*     ) 

the  healthy  frame.  When  this  act  of  undoing, 
or,  in  other  words,  of  unfitting  it  for  the  per- 
formance of  its  accustomed  and  useful  functions, 
was  accomplished,  the  constitution  was  af- 
firmed to  be  infected:  as  was  observed  in  a 
preceding  paragraph*  infection  was,  in  one 
of  its  senses,  but  another  term  for  dying  or 
imparting  colours.  In  many  forms  of  dis- 
tempers excited  by  pestilential  air,  there  was 
observed,  in  addition  to  the  other  symptoms 
of  debility,  &c.  a  remarkable  change  of  com- 
plexion. In  many  cases  the  patients  looked 
almost  as  if  they  had  been  dyed,  or  coloured 
with  some  tinging  material.  This  confirmed 
the  notion  of  infection  having  penetrated  the 
body,  and  wrought  a  change,  as  evident  to 
the  eyes  of  others  as  uncomfortable  to  the 
feelings  of  the  individual  himself.  And  by 
this  process  of  the  human  mind,  it  seems  to 
have  been  accepted  and  understood,  that  a 
white  garment  put  into  dye-stuff,  pure  air 
exposed  to  septic  exhalations,  and  a  healthy 
animal  acted  upon  by  a  pestilential  atmos- 
phere, Avere  all  examples  of  "  infection" 
The  term  was  applied  to  another  case. 
When  any  thing  noxious  was  added  to  whole- 


(     15     ) 

some  drink,  it  was  declared  to  be  infected, 
that  is,  to  be  undone  or  spoiled  for  the  natu- 
ral and  intended  purpose  of  slaking  thirst 
healthily.  The  beverage  was  infected ;  i.  e* 
the  pure  liquor  has  had  something  infused 
into  it,  by  which  it  has  been  vitiated  or  poi- 
soned.    Hence  the  verse  can  be  interpreted: 

"  Pocula  si  quando  ssevx  infecere  noverc<e." 

Having  thus  discussed  the  history  of  these 
words,  I  shall  observe  that  they  all  refer  to 
popular  and  not  to  scientific  distinctions  in 
things.  They  may  perhaps  answer  well 
enough  for  the  purposes  of  ordinary  conver- 
sation, but  possess  not  sufficient  distinctness 
for  those  of  medical  and  philosophical  lan- 
guage. 

Considering  the  matter  with  the  best  in- 
formation I  have  had,  there  appear  to  be 
but  two  great  operations  in  nature,  for  pre- 
paring or  engendering  noxious  fluids.  The 
former  of  these  is  accomplished  by  the  instru- 
mentality of  the  living  vascular  action  of  ani- 
mal-, and  ii  may  be,  of  vegetables.  The 
latter  t&  produced  by  a  putrefactive  process 
taking  place  in  certain  organized  bodies  alter 


(  Id  ) 

death.  To  signify  these  two  grand  natural 
processes,  there  ought  to  be  invented  two 
suitable  and  appropriate  terms.  But  as  such 
an  innovation  in  the  technology  of  the  pro- 
fession might  not  be  right,  I  shall  employ 
the  two  words,  Contagion  and  Infection,  to  de- 
note them. 

When  noxious  fluids  are  produced  by  liv- 
ing vascular  action,  I  call  them  Contagion: 
When  they  are  the  offspring  of  putrefaction, 
I  term  them  Infection. 

But  as  this  subject  has  been  stated  with 
great  perspicuity  in  that  valuable  periodical 
work,  the  Medical  Repository;  a  work 
which  is  an  ornament  and  an  honour  to  our 
nation,  as  well  as  our  city;  I  shall  quote  the 
passage  (vol.  v.  p.  186.) 

"  That  vitiated  product  of  living  vascular 
action,  which  can  excite  in  a  well  person  a 
disease  like  that  by  which  itself  was  pro- 
duced, and  continue  indefinitely  to  do  so 
after  being  transferred  from  one  body  to 
another,  will  be  denominated  Contagion ;  and 
lues,  vaccinia,  measles,  and  small-pox,  will 
be  considered  examples  of  it.  On  the  other 
hand,  that  venomous  offspring  of  putrefaction 


(     17     ) 

going  on  in  some  of  the  kinds  of  organic 
matter  after  death,  or  separation  from  the  liv- 
ing frame,  which  disorders  the  healthy  func- 
tions without  being  specifically  communica- 
ble, and  without  the  power  of  communi- 
cating itself,  will  be  called  Infection;  and 
typhus,  dysentery,  plague,  and  yellow-fever 
will  be  given  as  instances/' 


CHAP.  II. 

MEDICAL    AND    PHYSIOLOGICAL 
CONSIDERATIONS. 


Wi 


E  now  proceed  to  the  medical  history  of 
our  subject.  In  describing  this,  we  shall  de* 
part  from  the  common  mode  of  mentioning 
the  symptoms,  diagnosis,  &c.  and  offer  such 
reflections  as  have  occurred. 

It  appears  evident  that  the  combination  of 
elementary  substances,  which,  when  applied 
externally,  would  occasion  the  disorders  com- 
monly called  "  lovers,"  would  do  the  same, 
if  they  came  in  contact  with  the  internal  parts. 
Thia  is  woll  shown  in  a  piece  published  first 
in  the  New-York   Magazine,  in   \1(J",  and 

c 


(      18     ) 

afterwards  in  the  Medical  Repository  for  that 
year.  The  principal  points  which  appeared 
at  that  time,  were,  that  septic  acid  frequently 
existed  in  the  alimentary  canal  as  an  exciting 
cause  of  fevers,  and  that  neutral  salts  were 
more  useful  than  other  cathartics  in  such 
cases,  because  a  great  proportion  of  them 
could  neutralize  that  acid  by  means  of  the 
superior  attraction  existing  between  it  and 
their  alkaline  bases. 

Doctor  William  Bay,  who  graduated  in 
physic,  in  May,  1797,  in  this  college,  chose 
Dysentery  as  the  subject  of  his  Inaugural  Dis- 
sertation ;  and  having  adopted  the  above  prin- 
ciple, endeavoured  to  show  that  if  septic  acid 
was  the  exciting  cause,  neutral  salts,  in  which 
potash  and  soda  are  united  to  the  weaker  acids, 
were  very  efficacious  remedies.  This  dissert 
tation  fell  into  the  hands  of  the  monthly  re- 
viewers in  London,  and  the  writer  of  the  cri- 
ticism upon  it  rejected  the  doctrines  con-* 
tained  in  it,  both  practical  and  theoretical. 
And  more  recently,  in  one  of  the  numbers 
of  the  Monthly  Review,  for  1801,  the  writer 
of  the  criticism  upon  Dr.  Chisholm's  Essay 
on  Malignant  and  Pestilential  Fever,  speaks 


(  IS  ) 

disrespectfully  of  that  excellent  work,  be- 
cause the  author  has  advanced  doctrines  de- 
rived from  the  same  source.* 

Anatomists  have  agreed  that  the  cuticle 
reflected  or  continued  over  the  lips  at  the 
mouth,  passes  down  the  pharynx  and  oeso- 
phagus, and  after  lining  the  stomacH  and 
intestines,  both  small  and  great,  is  connected 
again  with  the  true  skin  at  the  verge  of  the 
anu«.  The  inside  of  the  body  then,  or  what 
is  called  the  alimentary  canal,  in  all  its  turn- 
ings and  windings,  is  a  surface  coated  with 


*  Vide  the  note,  page  14  of  Chisholm's  2d  volume. 

"  See  the  case  of  the  manufacturers  of  soap  and  candles 
in  the  city  of  New-York,  stated  and  examined,  &c.  published 
by  the  association  of  tallow-chandlers  and  soap-makers." 
The  advocate  employed  on  this  occasion  was  Dr.  Mitchill, 
the  ingenious  and  learned  Professor  of  Chemistry  in  Colum- 
bia College  ;  and  the  scientific  knowledge,  the  general  erur 
dition,  the  good  sense,  and  the  elegant  language  displayed 
in  the  course  of  his  argument,  in  support  of  his  clients,  must 
secure  the  admiration  and  applause  of  those  who  read  his 
"  Remarks  on  the  Proceedings  of  (lie  Legislature  of  the 
State  of  New- York ;"  and  his  "  application  of  the  Mitchillian 
Doctrine  of septic  fluids,  to  the  processes  carried  on  in  seve 
ral  branches  of  handicraft  business,  particularly  the  making 
pf  soap  and  candles,"  I.e..  Without  a  hyperbole,  he  may 
■  be  considered,"  to  use  his  own  language,  u  as  haviug 
■  nature  in  her  work-shop,  examined  her  collection  ol 
discovered  which  of  them  she  i  mployec| 
in  this  fearful  manufacture  (the  acid  of  putr     ction  or  infqe- 

\lii<h,  like  the  poisoned  shirt  of  llenule;,  enwrap 


(      20      ) 

an  epedermis  in  connection  with  the  muscu- 
lar, vascular,  and  nervous  parts  beneath,  with- 
out the  intervention  of  a  true  skin.  It  resem- 
bles, in  this  respect,  cicatrization  on  the  limbs, 
or  other  external  parts  of  the  body,  where 
spots  that  had  been  ulcerated,  are  skinned 
over  after  a  destruction  of  a  portion  of  the 
cutis  vera.  Such  places  are  tender,  and  more 
liable  than  others  to  accidents. 

We  call  the  stomach  and  intestines  a  part 
of  the  internal  structure  of  an  animal.  There 
is  one  sense,  in  which  this  is  hardly  correct, 
or  is  apt  to  mislead.  Their  internal  structure 
is  as  much  an  inside  as  the  barrel  or  bore  of 
zpump  is  the  inside  of  that  machine.  They 
are  open  at  both  extremities,  the  substances 
they  transmit  are  forced  in  at  one  end,  and 
expelled  at  the  other,  or  at  some  intervening 
outlet.  Air  and  water  move  easily  through, 
and  are  applied  freely  to  their  insides  as  well 
as  to  their  outsides:  and  besides  those  two 
fluids,  a  variety  of  substances  mingled  writh 
them,  even  to  the  thickest  consistence  that 
can  pass  the  valves,  are  pushed  along  their 
cavities.  The  bore  of  a  pump  is  thus,  strictly 
speaking,   an  outside  surface,  or  at  least  as 


<     21     ) 

commonly  and  indeed  more  exposed  than 
that  which  is  ordinarily  termed  the  outside. 
The  perforation  through  the  body  of  an  ani- 
mal, extending  from  the  mouth  to  the  anus, 
ought  to  be  deemed  an  external  surface,  or, 
at  least,  a  surface  as  much  or  more  exposed 
to  harm  and  accident,  than  any  part  of  the 
external  or  cuticular  surface.  It  is  the  tho- 
roughfare of  every  thing  put  into  it  for  the 
purposes  of  hunger,  thirst,  gluttony,  intem- 
perance, and  medicine.  The  alimentary 
canal  being  thus,  like  the  pump,  in  almost 
constant  action,  and  besides  the  perpetual  con- 
duct of  foul  and  noxious  matters,  will  often 
get  out  of  order,  and  of  course  stand  in  need 
of  frequent  repairs. 

One  of  the  accidents  to  which  this  inter- 
nal apparatus  is  frequently  subjected,  is  called 
"  Dysentery,'"  and  has  been  known  by  a  sy- 
nonymous word  from  a  remote  antiquity. 

Such  persons  as  subsist  chiefly  on  oily,  gela- 
tinous farinaceous,  and  saccharine  food,  arc 
V(  ry  little  incommoded  by  this  disease.  On 
the  other  hand,  the  victims  of  its  violence 
;ire  commonly  such  as  cat  animal  food  hear- 
tily,  particularly  that  which  is  lean.     In  the 


(     22     ) 

American  and  British  service,  both  by  sea  and 
land,  dysentery  is  nearly  connected  with  the 
beef -ration,  which  is  dealt  out  to  the  seamen 
and  soldiers.  Our  experience  in  New- York 
has  convinced  us  of  the  readiness  of  beef  to 
corrupt,  and  of  the  offensiveness  and  viru^ 
lence  of  the  gases  which  exhale  from  it  during 
that  process.  We  know  these  vapours  have 
very  often  produced  dysentery  in  the  repackers 
and  salters  of  beef,  who  were  exposed  to  it. 
And  from  a  variety  of  testimony  it  may  be 
concluded,  that  this  deleterious  effluvium 
from  beef  is  septic  acid  (the  acid  of  azote)  in 
a  volatile  form.  Of  a  number  of  persons  ex-» 
posed  to  this  septic  effluvium,  some  were 
seized  with  dysentery  and  others  with  fever. 
Such  a  disposition  and  quality  we  know  to 
reside  in  beef,  which  I  have  given  as  an  ex^ 
ample,  and  doubtless  inhere  in  all  other  lean 
animal  substances. 

Beef,  in  a  corrupting  condition,  called 
tainted  or  semi-putrid,  is  not  an  uncommon 
article  of  diet  in  armies  and  navies.  Whe- 
ther this  vitiation  arises  from  the  small  quan^ 
tity  of  muriate  of  soda  (sea  salt)  or  from  an 
adulteration  of  the  muriate  of  soda  applied, 


(     S3     ) 

or  from  an  inherent  predisposition  in  the  beef 
to  spoil,  the  ultimate  effect  is  nearly  the  same- 
It  becomes  charged  with  that  acid,  which  is 
capable  of  producing  those  mischievous  ef- 
fects in  the  alimentary  canal,  the  aggregate  of 
which  is  denominated  Dysentery.  Or,  as  the 
septic  poison  in  the  meat  acts  upon  a  secret- 
ing surface,  it  may  cause  zjlux  in  some  con- 
stitutions, as  well  as  a  dysentery  in  others,  and 
act  as  a  cause  of  some  species  of  diarrhoea. 
If  absorbed,  it  stimulates  the  sanguiferous  sys- 
tem to  morbid  action,  and  induces  that  condi- 
tion thereof  called  "  Fever."  Being  of  an 
acid  quality,  it  irritates  the  orifice  of  the  com- 
mon bile-duct,  and  provokes  a  more  free  se- 
cretion and  supply  of  the  gall.  This  alkaline 
fluid  from  the  liver,  in  moderate  forms  of 
disease,  is  generally  excreted  copiously,  and 
thus  neutralizes  the  exciting  cause.  As  the 
bile  is  plentifully  prepared  and  discharged, 
diseases  in  which  it  abounds  are  com- 
monly  culled  "  Bilious;"  and  the  ordinary 
opinion  is,  that  the  bile  itself  is  the  peccant 
matter  or  cause  of  the  malady.  But  this  no- 
tion  is  very  erroneous*  The  bile  is  but  the 
effect,  and  not  the  came.     And  the  reason 


(     24     ) 

wherefore  it  runs  so  readily  and  plentifully* 
is  to  correct  the  mischievous  quality  of  the 
offending  cause  in  the  stomach  and  intes- 
tines, whether  engendered  there  or  taken 
in  from  without:  accordingly,  some  of  the 
worst  forms  of  dysentery,  and  other  malig- 
nant distempers,  are  those  in  which  the  bile 
is  excreted  from  its  viscus  in  scanty  propor- 
tion, or  not  at  all. 

Though  the  alimentary  canal  may  receive 
the  septic  acid  or  exciting  cause  of  dysentery 
from  the  atmosphere,  or  in  tainted  beef  or 
other  lean  animal  substance,  these  are  not  the 
only  ways  by  which  it  may  come  in  contact 
with  the  stomach  and  intestines.  Lean  ani- 
mal matter,  as  beef,  mutton  or  fish,  may  be 
eaten  in  its  entire  and  uncorrupted  state;  but 
it  may  be  so  long  retained  in  the  body,  especi- 
ally in  the  large  intestines,  that  it  may  corrupt, 
and  septic  acid  be  formed  from  it  there;  and 
this  accident  is  very  liable  to  befall  those  per- 
sons who  are  subject  to  indigestion  and  costive- 
ness,  or,  in  other  words,  who  are  not  regular 
in  respect  to  alvine  evacuations.  In  such 
cases  scybala  may  be  formed  in  consequence 
of  too  great  absorption  of  the  fluids  of  the 


(     25     ) 

intestines,  and  from  the  residuary  lumps  of 
hardened  faeces,  containing  some  septic  acid, 
and  engendering  more,  is  the  spasmodic  con-^ 
dition  of  the  colon  induced, 

A  cause  of  dysentery  may  thus  be  received 
into  the  body  from  without,  or  it  may  be  pro- 
duced within  it  from  the  decomposition  of 
such  articles  of  food  as  contain  septon  or  azote. 
The  former  is  the  distemper  deemed  infectious 
or  endemic;  the  latter,  the  sporadic.  But  it 
may  so  happen  on  board  a  ship  or  in  a  camp, 
that  many  persons  of  a  crew,  or  a  detachment 
fed  on  similar  rations,  may  fall  sick  together 
from  the  unwholesome  quality  of  their  food, 
without  any  vitiation  in  the  air  at  all :  and  the 
disease,  though  strictly  sporadic,  may  thus  as- 
sume the  guise  of  an  endemic.  The  like 
may  happen  in  neighbourhoods  and  districts 
in  the  country,  where  the  inhabitants  live 
very  much  alike,  or  subsist  on  nearly  similar 
articles  of  diet,  and  feed  on  meat  cured  with 
muriate  of  soda,  (generally  adulterated,  and 
rarely  or  never  purified  in  America),  bought 
at  the  same  -tore,  and  part  of  the  same  parcel. 

Il'  there  should  happen  a  condition  of  the 
digestive  organs,   wherein   tl»<-  gall  should 

p 


(      26     ) 

cease  to  flow  at  a  time  when  oxygenated  sep~ 
ton,  from  any  of  the  sources  already  men- 
tioned,  abounded  in  the  alimentary  canal, 
disease  might  be  expected  to  ensue.     But 
such  a  disorder  would  not  be  ?c  mere  jaundice, 
from  a  retention  of  bilious  matter  tinging  the 
skin  with  an   icteritious  or  yellow  hue,  but 
would  be  a  disease  from  poison,  causing  the  sto- 
mach and  upper  intestines  to  invert  their  mo- 
tions and  expel  their  contents;  creating  pain, 
flatulency,  heat,  and  inward  distress ;  and  stir- 
ring up  more  or  less  of  "fever"  by  an  imbibi- 
tion of  some  of  the  septic  venom:  to  all  which 
there  might  be  superadded  the  peculiar  and 
characteristic  symptoms  of  dysentery.      For 
violent  fits  of  the  American  yellow  fever  have 
occurred  in  cases  where  the  stomach  and  in- 
testines had  been  much   disordered,  termi* 
nating   favourably  after  tormina,  tenesmus, 
and  slimy  stools  mixed  with  blood.     Whence 
the  connection  between  yellow  fever  and  dy- 
sentery can  be  discerned;  both  arising   from 
the  same  general  cause,  and  chiefly  differing 
in  the  part  of  the  body  particularly  invaded 
by  that  cause.     Dysentery  may  exist  without 
being  accompanied  with  yellow  fever,  and 


(     27     ) 

yellow  fever  may  arise  unattended  by  bloody- 
flux.  Yet  though  it  may  be  easy  to  distin- 
guish the  extremes,  there  is  nothing  more 
difficult  than  the  establishment  of  the  limits 
between  the  two,  in  cases  where  they  are 
blended  and  incorporated  with  each  other. 
In  short,  though  Nosology  may  distinguish, 
and  sever  and  place  them  far  asunder,  sci* 
c?ice,  with  better  information,  traces  their 
genealogy  from  one  original,  and  finds  them 
intimate  kindred,  descended  from  the  same 
parent. 

This  is  by  no  means  a  new  opinion.  If 
we  look  back  into  history,  we  will  find  that 
the  ancients  were  also  well  acquainted  with 
this  fact.  Diodorus  Siculus,  who  has  always 
been  considered  a  correct  and  faithful  histo- 
rian (lib.  xii.  cap.  2.)  gives  an  account  of 
the  expedition  of  the  Athenians  under  Eury- 
medon  and  Demosthenes  against  Syracuse. 
This  was  about  the  410th  year  before  the 
Christian  sera.  A  plague  broke  out  in  their 
camp  adjoining  the  city,  owing  loan  offensive 
marsk  in  the  neighbourhood,  and  raged  and 
increased  to  such  a  degree,  that  a  great  part 
of  the  army  perished. 


(     28     )' 

t)iodorus  (lib.  xiv.  cap.  7.)  describes,  with 
some  detail,  the  distemper  which  invaded  the 
Carthaginians  in  the  year  before  Christ  394?, 
When  encamped  on  the  same  ground,  near 
Syracuse,  that  had  been  formerly  occupied 
by  the  Athenians.  He  calls  it  a  "  plague;'* 
says  it  was  first  ascribed  to  the  vengeance  of 
the  gods,  for  the  rifling  and  plundering  of 
the  temples  of  Ceres  and  Proserpine.  But 
he  considers  the  place  itself  as  the  great  occa- 
sion of  the  disorder.  The  ground  was  marshy 
and  spungy — great  multitudes  of  men  were 
thronged  together — it  was  summer — the 
nights  were  chilly  and  the  days  intolerably 
hot — the  pestilential  air  was  blown  upon 
them  by  a  southerly  wind — there  was  no 
idea  of  importation  from  foreign  places— the 
symptoms  Were  "  catarrhs  and  swellings  of  the 
throat,  which  were  caused  by  the  stench  of 
the  bodies  that  lay  unburied,  and  the  putre* 
faction  of  the  soil.  Then  followed  fevers, 
pains  in  the  back,  heaviness  of  the  loins,  dysen- 
teries, blotches  and  boils  over  the  whole  body. 
Some  ran  mad,  beating  every  one  they  met." 

The   exciting  cause   of    dysentery  being 
known,  there  is  no  difficulty  in  administer- 


(     29     ) 

Ing  remedies  which,  in  most  cases,  will  de* 
6troy  or  expel  it.  From  the  known  efficacy 
of  alkaline  salts  to  correct  putrid  taints  and 
tendencies  in  beef,  and  in  all  animal  sub- 
stances, pot-ash  and  soda  present  themselves 
first  on  the  list  of  antidysenteric  remedies. 
"We  know  they  can  correct  offensive  and  vi- 
rulent qualities  of  the  fasces  out  of  the  body, 
or  in  beef  after  it  has  been  eaten,  and  natu- 
rally enough  can  believe  they  will  act  in  a 
similar  way  in  the  intestines,  provided  they 
can  by  any  means  be  conveyed  there. 

Notwithstanding  the  prejudices  of  some 
against  the  employment  of  alkalies,  and  the 
belief  of  others  in  their  being  unwholesome 
and  improper  in  the  extreme;  that  acids  are 
the  great  and  useful  antiseptics,  and  of  course, 
by  the  rule  of  opposites,  that  alkalies  are 
endowed  with  qualities  directly  the  reverse: 
Notwithstanding  all  this,  I  am  one  of  those 
who  have  an  entire  confidence  in  the  superior 
Honey  of  alkaline  medicines. 

It  is  known  that  in  some  parts  of  our  coun- 
try the  persons  who  practice  the  veterinary 
art,  give  to  horses,  and  other  creatures  weak 
Mlkaiine  ley,   made  by  boiling  wood  aslic*  in  wa- 


(     30      ) 

ter,  for  the  colic  and  scowers.  And  occa* 
sionally  the  country  people  will,  in  similar 
diseases,  take  some  of  the  like  medicine  in- 
ternally for  their  own  relief.  Besides,  it  is 
said  that  during  a  severe  dysentery  which 
prevailed  among  the  Indians  near  Detroit, 
some  years  ago,  the  prescribers  of  medicine 
among  the  savages  administered  weak  ley  of 
pot-ash  to  the  sick,  and  with  admirable  suc- 
cess. 

A  strong  solution  of  muriate  of  soda,  di- 
luted with  a  third  of  sharp  acetic  acid,  has 
been  often  administered  to  dysenteric  patients, 
as  is  credibly  reported,  with  excellent  ef- 
feet.  After  recommending  this  remedy,  and 
witnessing  the  operation  of  the  brine,  swal- 
lowed as  hot  as  the  patient  could  bear,  in  doses 
of  two  or  three  table  spoons  full,  repeated  fre- 
quently, I  have  had  reason  to  think  favourably 
of  it,  as  an  antidysenteric  prescription.  And 
what  seems  more  capable  of  being  deduced 
in  favour  of  alkalies  in  the  intestinal  canal,  is 
the  known  constitution  of  the  gall ;  a  secreted 
fluid  abounding  with  the  very  alkali  which  is 
the  basis  of  common  salt,  and  in  times  of 
health  perpetually  mingling  with  the  alimen- 


(     31     ) 

tary  mass,  for  the  purpose  apparently  of  pre- 
venting its  degeneracy  to  something  noxious. 
It  seems  therefore  clear,  that  a  solution  of 
carbonate  of  soda  in  water  might  be  employed 
at  any  time  in  aid  of  the  bile,  or  in  some 
measure  as  a  substitute  for  it  if  deficient,  and 
thus  allay  the  uneasiness  and  pain  frequently 
caused  by  it. 

We  know  that  gall  has  been  long  employed 
by  dyers  and  scourers  to  cleanse  silks  and 
delicate  stuffs,  and  to  free  them  from  spots 
and  stains;  it  is  therefore  not  improbable  that 
this  saponaceous  liquid  acts  in  a  like  man- 
ner in  the  alimentary  canal,  deterging  and 
cleansing  the  whole  passage,  as  far  as  its 
strength  and  virtues  extend. 

Alkalies  promise  to  be  useful  on  another 
account.  The  discharge  per  anum  in  some 
of  our  pestilential  and  dysenteric  diseases, 
are  so  sharp  and  corrosive  as  to  excoriate  the 
skin  around  the  anus,  and  to  excite  inflam- 
mation almost  wherever  they  touch  an  exter- 
nal part.*     When  shirts,  sheets,  or  drawers 

•  In  Lowthorp'fl  Abridgment  (Pliil.  Trans,  vol.  iii.  p. 
232.)  may  be  seen  an  account  of  Mr.  Bayle'o  Experiment 
(tinted  to  the  Royal  Society  in  1664,  of  the  antiseptic 
power  of  fiii<j  urinous  spirit,  or  spirit  of  sal  ammoniac,  in 


(     52     ) 

are  besmeared  with  these  or  any  other  kind* 
of  fsecal  matter,  alkaline  leys  are  always 
competent  to  destroy  their  activity,  to  carry 
them  off,  and  to  leave  the  garment  clean 
and  uninfected  in  the  hands  of  the  washer. 

If  alkalies  can  accomplish  these  desirable 
objects  in  alimentary  egesta  immediately  after 
their  evacuation,  there  remains  no  doubt  of 
their  capability  to  accomplish  as  good  a  pur- 
pose, if  injected  into  the  intestinum  rectum, 
and  made  to  penetrate  the  colon  itself. 

In  addition  to  all  this,  it  seems  to  be  estab- 
lished as  a  truth,  that  in  those  parts  of  the 
United  States  where  carbonate  of  lime  con- 
stitutes the  great  strata  of  the  earth,  and 
where  of  course  the  water  contains  a  consider- 
able quantity  of  lime  in  solution,  dysenteric 
complaints  are  comparatively  rare  and  mild, 


preserving  blood  yet  warm  from  the  veins,  from  coagulation 
and  from  putrefaction  a  long  time.  This  experiment,  he  says, 
he  devised  to  show  the  "  amicableness  of  volatile  spirits  with 
the  blood." 

In  the  same  volume  (p.  115.)  in  a  paper  on  dysentery, 
may  be  seen  the  writer's  opinion  that  the  sharp  corrosive 
humours  in  that  disease,  "  are  of  the  nature  of  aqua-fortis 
and  spirit  of  nitre,  and  which  eat  away  the  tunicles  of  the 
intestines  and  mouths  of  the  vessels."  For  correcting  this 
he  adds  "  the  absorbent  earth  crabs-eyes  to  his  prescript 
lion." 


C     33     ) 

The  lime-water  which  the  inhabitants  of 
these  situations  constantly  drink,  acting  al- 
ways as  a  preventive  of  the  disease,  or  as  a 
corrector  of  its  exciting  cause  within  the  body. 

We  shall  next  consider  which  of  the  alka- 
lies will  be  preferable,  and  also  what  form  or 
combination  of  either  will  answer  best  the 
purpose  of  prescription. 

To  give  the  alkalies  in  their  simple  or 
Caustic  condition  would  be  injurious:  the  dis-* 
ease  would  be  aggravated,  not  cured  by  such 
harsh  medicines* 

I  begin  with  pot-ash  (salt  of  tartar)  and 
would  give  the  carbonate  in  dysentery,  mak- 
ing a  solution  of  it  of  such  a  strength  as,  on 
being  tasted,  should  not  affect  unpleasantly 
the  mouth.  To  this  sugar  may  sometimes 
be  added  to  help  the  taste.  A  table  spoon- 
ful may  be  given  every  quarter  or  half  hour, 
according  to  circumstances,  until  the  patient 
experience  relief.  And  in  order  to  render 
Its  effects  more  speedy  and  certain,  cnemata 
of  the  same  weak  alkaline  solution  should  be 
given  from  time  to  time,  either  alone  or  with 
broth  or  starch;  occasionally  with  the  addi- 
tion of  a  binall  quantity  of  thebaic  tincture 

£ 


(     34     ) 

to  the  mixture  taken  by  the  mouth,  as  well 
as  to  that  administered  per  anum.  Much  be-> 
nefit  will/  I  presume^  be  derived  from  this 
mode  of  treatment. 

On  trials  with  carbonate  of  magnesia,  it 
appears  to  be  not  sufficiently  strong  and  effi- 
cacious. Its  powers  are  greatly  inferior  to 
carbonate  of  pot-ash.  Though  its  qualities 
are  good  as  far  as  they  go,  yet  they  are,  how- 
ever, too  feeble  to  be  relied  on  in  eases  where 
decisive  and  energetic  practice  is  required. 

The  disagreeable  taste  of  pot-ash  is  some- 
times objected  to  by  patients.  When  this 
happens,  carbonate  of  soda  may  be  employed. 
This  is  much  less  unpleasant,  and  may  be 
tasted  and  swallowed  with  ease :  indeed,  on 
reflecting  that  soda  is  the  basis  of  the  bile,  and 
of  the  culinary  salt,  which  we  constantly  and 
by  instinct  as  it  were,  swallow  with  our  food, 
it  appears  to  be  more  natural  and  friendly  to 
the  constitution  than  either  pot-ash  or  mag- 
nesia ;  and  for  this  reason  it  is  that  neutral 
salts,  with  a  basis  of  soda,  are  preferable  to 
all  others,  for  their  efficacious,  safe  and  kind 
operation.  The  bringing  them  more  genej 
rally  into  use  would  be  a  great  improvement 
in  the  practice  of  physic. 


(     35     } 

The  formula  of  giving  carbonate  of  soda 
in  dysenteric  cases  is,  a  solution  in  water  strong 
enough  to  be  taken  into  the  mouth  and  su> 
mach  without  smarting,  or  any  other  incon- 
venience. The  dose  is  from  a  tea  spoonful 
to  two  or  three  table  spoonsful;  and  the 
times  of  administration  are  every  quarter  or 
half  hour,  or  every  second  and  third  hour, 
as  the  symptoms  seem  to  require.  Portions 
of  the  same  solution  are  applied  in  the  form 
of  glister,  to  be  retained ;  and  they  are  very 
useful  and  efficacious  in  allaying  tenesmus, 
and  diminishing  the  frequency  of  evacuar 
'{ions.  I  have  seen  several  cases  of  dysentery 
cured  with  this  plain  prescription  in  the  tttm 
modes  just  mentioned. 

Sometimes,  however,  the  carbonate  of  soda 
may  be  dissolved  in  mint-water,  instead  of 
common  water:  and  occasionally  the  addi- 
tion of  some  laudanum,  where  the  patient 
suffers  much  pain,  lias  bad  a  happy  effect. 
I  think  whore  alkalies  are  prescribed  there 
need  be  Less  hesitation  to  administer  opiates 
than  in  conjunction  with  any  oilier  remedy. 
f  ol.  ricirri,  or  of  ol.  olivarum,  may 
a  tonally  interposed  with  advantage,  as. 


(     36    ) 

mild  oils  have  a  tendency  to  obtund  the  acid 
exciting  cause  of  the  malady.  The  same 
quality  probably  belongs  to  all  fat  and  greasy 
substances  that  are  not  rancid.  On  the  con- 
trary, lean  meats  are  found  universally  bad 
for  dysenteric  patients,  who  ought  always  to 
be  interdicted  their  use,  I  have  known  a 
convalescent  relapse  into  dysentery  after  eat- 
ing a  dinner  of  beef.  For  food  we  would  re- 
commend rice,  tapioca,  sago,  panada,  and  ge- 
nerally farinaceous  and  saccharine  substances; 
and  likewise  soups  and  jellies,  if  the  sick  have 
an  inclination  for  them. 

In  all  these  kinds  of  food  an  advantage 
would  be  derived  from  sprinkling  in  as  much 
muriate  of  soda  as  can  be  conveniently  and 
agreeably  done. 

By  these  means  the  alimentary  canal  can 
in  general  be  sufficiently  alkalized.  We  al- 
kalize our  clothes  and  the  outer  surface  of  our 
bodies  with  solutions  of  soap  and  weak  leys, 
to  keep  ourselves  clean  and  healthy.  The 
intestines  are  alkalized  by  the  bile,  and  their 
internal  surface  is  protected  by  the  mediation 
of  that  admirable  liquid,  which  is  prepared 
and  applied  without  our  knowledge  or  con^ 


(     37     ) 

currence,  by  the  most  excellent  provision  in 
the  animal  economy.  When  the  gall  is  in- 
sufficient, it  becomes  the  physician  to  alka- 
lize the  intestines  and  their  contents,  by  some- 
thing as  nearly  allied  to  the  bile  as  he  can 
find.  Soda  is  such  a  substance.  Perhaps 
camomile,  gentian,  or  some  other  bitter,  would 
improve  it,  by  making  it  resemble  the  natu- 
ral secretion  more  nearly. 

The  carbonates  of  pot-ash  and  soda  seem 
to  be  better  in  dysentery  than  the  combina- 
tion of  those  simple  salts  with  stronger  acids. 
They  arc  more  easily  decompounded,  and 
while  the  septic  acid  of  the  intestines  joins 
the  alkalies,  to  form  septitcs  of  pot-ash  and 
soda,  the  carbonic  acfd  is  extricated  to  pro- 
duce the  agreeable  effect  of  which  it  is  sup- 
posed capable,  and  for  which  it  has  been  long 
celebrated.  But  it  ought  to  be  remembered 
that  tbe  tart  rites  of  pot-ash  (soluble  tartar),  and 
of  soda  (Rochelle  salt),  and  phosphate  of  soda 
are  very  valuable  remedies.  And  to  these 
\m  may  add  muriate  of  soda,  by  which  is 
meant  the  compound  formed  by  mere  tnuri* 
acid  unci  goda,  and  not  the  adulterated 
and  heterogeneous  composition  forming  the 


(     38     ) 

sea-salt  commonly  in  use.  No  objection 
ought  to  arise  against  the  use  of  these  alkaline 
remedies,  in  ordinary  cases,  as  being  too  fiery 
and  pungent;  nor  even  in  cases  of  inflamma- 
tion and  ulceration  of  the  intestines:  for  it 
is  shown,  in  a  memoir  in  the  Medical  Repo- 
sitory, by  Dr.  Mitchill,  that  carbonates  of  pot- 
ash and  soda  are  very  substantial  helps  to  the 
surgeon,  when  applied  to  the  surface  of  foul 
and  eroding  ulcers.  And  from  their  internal 
use,  another  good  effect  will  ensue:  the  fasces 
will  possess  very  little  fastor,  and  no  infection, 
Nurses  and  attendants  may  perform  their  ser- 
vices commodiously,  and  without  hazard  of 
catching  the  distemper.  Under  the  use  of 
these  remedies  it  can  never  spread. 

Alkaline  remedies,  excellent  as  they  are, 
may  be  abused ;  and  for  want  of  proper  care 
'in  their  administration  and  continuance  the 
customary  good  effects  may  not  be  produced 
by  them  *.  but  they  can  do  a  great  deal;  for 
they  can  overcome  the  acid  exciting  cause  of  the 
dysentery,  and  prevent  its  further  mischievous 
operation  upon  the  intestines,  and  its  absorption 
into  the  system.  They  may  do  all  this,  and 
yet  not  be  capable  of  curing  every  case  that 
presents. 


(     ™     ) 

Inveterate  dysenteries  and  fluxes  will  often 
baffle  medical  skill,  and  end  fatally,  in  oppo- 
sition to  alkaline  and  all  other  remedies. 
After  the  stomach  has  lost,  in  a  considerable 
degree,  its  power  to  digest,  the  liver  to  fur- 
nish bile,  the  lacteals  to  imbibe  their  appro- 
priate fluid,  and  the  intestines  to  perform 
their  peristaltic  movements,  there  is  no  great 
prospect  of  recovery,  even  though  the  excit- 
ing cause  of  the  malady  should  have  been 
entirely  expelled  from  the  body.  Still  it  ap- 
pears, from  repeated  trials  and  careful  obser- 
vation, that  the  alkaline  plan  of  treatment 
which  we  have  described,  is  preferable  to 
every  other.  Rhubarb,  ipecacuanha,  cerated 
glass  of  antimony,  calomel,  and  Peruvian 
bark,  seem  to  be  very  inferior  remedies. 
None  of  them  promise  to  do  much  good,  fur- 
ther than  as  they  operate  as  cathartics.  And 
for  a  purgative  purpose,  the  neutral  salts 
which  we  have  enumerated  possess  a  decided 
superiority. 

THE    END, 


Date  Due 

9 

QuaeW 

Inaugu] 
terv 


3.7  sen- 


